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Rapid resolution of COVID-19 after faecal microbiota transplantation
  1. Jarosław Biliński1,2,
  2. Katarzyna Winter3,
  3. Marcin Jasiński1,
  4. Anna Szczęś4,
  5. Natalia Bilinska5,
  6. Benjamin H Mullish6,
  7. Ewa Małecka-Panas3,
  8. Grzegorz W Basak1,2
  1. 1 Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warszawa, Poland
  2. 2 Human Biome Institute, Gdańsk, Poland
  3. 3 Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
  4. 4 Department of Internal Medicine, Poviat Specialist Hospital in Stalowa Wola, Stalowa Wola, Poland
  5. 5 Department of Pediatric Gatroenterology and Pediatrics, Medical University of Warsaw, Warszawa, Poland
  6. 6 Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
  1. Correspondence to Dr Jarosław Biliński, Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warszawa, Poland; jaroslaw.bilinski{at}

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Recent publications demonstrate that SARS-CoV-2 may undergo prolonged shedding in stool, and that gut microbiome perturbations associate with COVID-19 severity.1 2 Faecal microbiota transplant (FMT) restores a damaged gut microbiome and may impact on immune responses,3 including in the respiratory system (‘gut–lung axis’)4; such microbiome-immune signalling may result in lung-epithelial resistance to SARS-CoV-2.5 We describe two interesting cases of patients treated with FMT primarily to treat Clostridioides difficile infection (CDI), but which coincidentally were performed just before initial symptoms of coexisting COVID-19 (figure 1).

Figure 1

Timeline of the procedures performed in patients with CDI, which coincidentally occurred during COVID-19 early stage infection. Created with CDI, Clostridioides difficile infection; ESBL, extended-spectrum beta-lactamase, FMT, faecal microbiota transplant.

Patient 1: an 80-year-old man with multiple comorbidities, including prior CDI, was admitted to hospital with pneumonia/sepsis. Following meropenem treatment, pneumonic features resolved, but CDI relapse occurred. Sequential vancomycin treatment and nasojejunal FMT were administered. On the day of FMT, he …

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  • Contributors JB made an investigation plan and prepared the draft of the manuscript. JB, KW, MJ, AS, NB, BHM, EM-P and GWB consulted on the research work and provided data. JB, MJ and BHM made the final version of the manuscript.

  • Funding BHM is the recipient of an NIHR Academic Clinical Lectureship (CL-2019-21-002). The Division of Digestive Diseases at Imperial College London receive financial and infrastructure support from the NIHR Imperial Biomedical Research Centre (BRC) based at Imperial College Healthcare NHS Trust and Imperial College London.

  • Competing interests JB and GWB are owners of Human Biome Institute, Poland. BHM has received consultancy fees from Finch Therapeutics Group, Massachusetts, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.